Starting Prophylaxis in Severe Hemophilia A — Previously Untreated Patients

This protocol addresses the initiation of prophylaxis in patients with severe hemophilia A who have had no prior treatment, or fewer than 5 exposure days to FVIII.

Clinical scenario: Severe hemophilia A; patient is previously untreated (no prior treatment or under 5 FVIII exposure days) and is initiating prophylaxis for the first time.

Approach (partial)

Current evidence-based guidance supports initiating prophylaxis with plasma-derived FVIII during the initial phase. The complete product selection rationale, sequencing, and monitoring parameters are detailed in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jtha.2024.05.026

In previously untreated individuals with severe hemophilia A who will start prophylaxis with a plasma-derived or standard half-life recombinant FVIII concentrate, the ISTH Hemophilia Guideline Panel suggests initial prophylaxis with plasma-derived FVIII over standard half-life recombinant FVIII concentrate (conditional recommendation, based on very low–certainty evidence ⨁◯◯◯).
Initial prophylaxis refers to the first 50 exposure days to FVIII.

View source ↗